{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:47:50Z","timestamp":1772110070655,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The aim of this paper is to describe the temporal progression and clinical picture of a 2-year-old child with infantile Refsum disease, as well as the diagnostic procedures performed; this case presented multiple hematologic, metabolic, and developmental complications and progressive disabilities. Genetic testing revealed a mutation of the PEX6 (Peroxisomal Biogenesis Factor 6) gene, and the metabolic profile was consistent with the diagnosis. Particularly, the child also presented altered coagulation factors and developed a spontaneous brain hemorrhage. The clinical picture includes several neurological, ophthalmological, digestive, cutaneous, and endocrine disorders as a result of the very long chain fatty acid accumulation as well as secondary oxidative anomalies. The study of metabolic disorders occurring because of genetic mutations is a subject of core importance in the pathology of children today. The PEX mutations, difficult to identify antepartum, are linked to an array of cell anomalies with severe consequences on the patient\u2019s status, afflicting multiple organs and systems. This is the reason for which our case history may be relevant, including a vast number of symptoms, as well as modified biological parameters.<\/jats:p>","DOI":"10.3390\/children10030530","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T03:03:23Z","timestamp":1678331003000},"page":"530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["PEX6 Mutation in a Child with Infantile Refsum Disease\u2014A Case Report and Literature Review"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6456-9744","authenticated-orcid":false,"given":"Ana-Maria","family":"Slanina","sequence":"first","affiliation":[{"name":"Department of Family Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Ia\u0219i 700115, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6348-2954","authenticated-orcid":false,"given":"Adorata-Elena","family":"Coman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Ia\u0219i 700115, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana-Teodora","family":"Anton-P\u0103duraru","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Ia\u0219i 700115, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2207-5129","authenticated-orcid":false,"given":"Elena","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Ia\u0219i 700115, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9349-4147","authenticated-orcid":false,"given":"Carmen-Liliana","family":"Barbacariu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Ia\u0219i 700115, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Otilia","family":"Novac","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Ia\u0219i 700115, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1239-8058","authenticated-orcid":false,"given":"Antoneta Dacia","family":"Petroaie","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Ia\u0219i 700115, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes-Iacinta","family":"Bacu\u0219c\u0103","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Ia\u0219i 700115, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela","family":"Manole","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Ia\u0219i 700115, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Cosmescu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Ia\u0219i 700115, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/ddrr.1113","article-title":"Peroxisome biogenesis disorders: Biological, clinical and pathophysiological perspectives","volume":"17","author":"Braverman","year":"2013","journal-title":"Dev. Disabil. Res. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1002\/ajmg.a.62110","article-title":"Twins with PEX7 related intellectual disability and cataract: Highlighting phenotypes of peroxisome biogenesis disorder 9B","volume":"185","author":"Masih","year":"2021","journal-title":"Am. J. Med. Genet. 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